Medigap Plan D Details

Find out how Medigap Plan D works and what it covers

Medigap Plan D Overview

Medigap Plan D is a Medicare Supplement Insurance plan that covers some of the gaps of Original Medicare. While, Medigap plan D covers many of the benefits offered by Medicare Supplement plans, it leaves two gaps in coverage.

Remember Medicare Plan D plans are designed to complement Original Medicare Part A and Part B. Below is a list of what you would pay under Original Medicare alone, and then what you would pay if you purchased Medigap Plan D.

Medigap Plan D Benefit Details

Benefits

Original Medicare Alone

Original Medicare With Medigap Plan D

Doctor Network

All Doctors that accept Medicare

All Doctors that accept Medicare

Part A Hospital Benefit Period Deductible

You pay $1,364*

You pay $0

Hospital days 61-90

You pay $335 per day per day

You pay $0

Hospital Days 91-150

You pay $670 per day per day (lifetime reserve days)

You pay $0

Beyond Lifetime Reserve Days

You pay 100%

You pay $0 up to an additional 365 hospitalization days.

Skilled Nursing Facility Care Days 1-20

You pay $0 (Part A deductible applies)**

You pay $0

Skilled Nursing Facility Care Days 21-100

You pay $167.50 per day

You pay $0

Hospice Respite Care

You pay 5%

You pay $0

First 3 Pints of Blood

You pay 100%

You pay $0

Additional Blood

You pay $0

You pay $0

Part B Annual Deductible

You pay $185

You pay $185

Ambulance

You pay 20% (Part B deductible applies)

You pay $0, after Part B deductible

Doctor’s Office Copays/Coinsurance

You pay 20% (Part B deductible applies)

You pay $0, after Part B deductible

Durable Medical Equipment

You pay 20% (Part B deductible applies)

You pay $0, after Part B deductible

Part B Excess Charges

You pay 100% (Part B deductible applies)

You pay 100%

Foreign Travel Emergency

You pay 100%

You pay 20%***

Out-Patient Surgery

You pay 20% (Part B deductible applies)

You pay $0, after Part B deductible

Urgent Care

You pay 20% (Part B deductible applies)

You pay $0, after Part B deductible

Next Steps for Medigap Plan D

The fine print of the Medigap Plan D Chart Above

*Medicare Part A deductible is broken down into 60 day benefit periods. You have to pay the deductible if you reenter the hospital after 60 days from discharge. Example: If you enter the hospital March 1st you’ll pay the Part A deductible. If you leave the hospital 5 days later and return to the hospital on July 6th, you will be charged the Part A hospitalization benefit again.

**For Skilled Nursing you must have a 3-day qualifying stay in the hospital to qualify for Skilled Nursing Facility care AND you’ll still pay the benefit period Part A deductible ($1,364).

***Foreign Travel Emergency requires a deductible of $250. You will have to have your emergency within the first 60 days of travel, and the plan has a lifetime coverage amount of $50,000.

Reader Comments and Questions

This is more of a statement than a question. So basically D is exactly like G except is doesn't cover excess charges. Am I reading that correctly?

The Great Questioner,
You are correct, Plan D has the same coverage as Plan G, but it doesn't cover Part B excess charges. Just remember, since less companies offer Plan D than G, you will may not have as many options originally, and not a lot of options to change your plan each year if you live in a state that has a Medigap Birthday Rule.
-Chris from https://www.senior65.com/

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